The Use of Fetal Bovine Collagen Dermal Repair Scaffold Associated with Increased Limb Salvage in Lower Extremity Wounds

Introduction: Many products are commercially available to aid the healing process in chronic wounds. One of these, is an acellular fetal bovine collagen matrix* (FBC) intended to help cellular repopulation and revascularization of the wound bed. We looked at whether there was a correlation between all-cause ipsilateral amputation and FBC use in lower extremity wounds.

Methods: Various Current Procedural Terminology (CPT) codes were used to identify 256 unique patients with treated for lower extremity wounds that were cared for by a Vascular Surgery Service at a large inner city tertiary care wound program from 2016-2018. Chart review was performed on each patient to collect data on the management of their wounds. Logistic regression analysis was performed with all-cause ipsilateral future amputation as the dependent variable.

Results: Out of the 256 patients managed, 34 required a future amputation in the ipsilateral extremity during the wound management. Patients who had received FBC therapy for their wound management were associated with decreased future amputation (OR 0.216, CI 0.063-0.735). We also noted that those who had debridement and product placed in the office versus the operating room had a decreased rate of future amputation (p<0.04).

Conclusion: This observation of increased limb salvage in patients with FBC placement could speak to improved wound healing in that group of patients, thus leading to decreased wound infections and infection related amputations. Further stratification of the cause amputation will be required to elucidate which particular group of patients this therapy aids the most. The observation of increased limb salvage in patients having in-office procedure can potentially be explained by patients with smaller wounds being managed in the office instead of the operating room. 

*Primatrix® Dermal Repair Scaffold